NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
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Asbestos Control Program
59.17 .hnetion OolUvaid. 9' Floor. Corona. NY 11368.6107
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ASBESTOS PROJECT NOTIFICATION
FORM I (ASSEslos It8P8CT10N REPORT) 1. 5iit_77
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When submitting this form at the NYC Department of SuIdinps, the original form and three (3) Oopies with oripinal
signatures are required. Submittal at do NYCOEP requires one copy of the form with original signatures. This ~~~1~
form must be submitted to the NYC DEP not less than one week in advance of the start of abatement activities.
i. FACI ITY
2. A tress 156 William St Borough Manhattan Zip
A 51-55 Beekman St, 73-85 Mn St 3. Block 93 4. Lot 20
5. Ty e of Facility 6. Name of Building
II. BUIDING OWNER
7. N e 156 William St. LLC 8. Contact Person
9. T # (212) 924-9690 Fax#
10. A dress City State Zip
III. GENERAL CONTRACTOR
h .P tme_______________________________________________________ Tel. #
IV. AS ESTOS ABATEMENT CONTRACTOR
12. me Benjamin Kurzban & Son Control 13. Contact Person Louie lannioo
14. ederal Employer ID. # _ _ _ _ _-P11 _
15. Tel. # (718) 531-2900 Fax # (718) 209-1808
16. Idress 1248 Ralph Avenue City Brooklyn State NY Zip 11236
V. THI D PARTY AIR MONITOR
17. Name Warren Panzaer. E.NG, ti EE tz-.S
__ 18. Contact Person Mt CUAEL NO LAN
19. F deral Employer ID. I'i_._. 11. - 20. Tel. # (212) 922-0077 Fax # (212) 922-0630
21. dress 228 East 45th St City New york State NY Zip 10017
22. imple Analysis Laboratory 23. NYS DOH ELAP #
VI. PR JECT INFORMATION
24. tarting date for this portion of work 7/8 / D Z Projected completion date 18 J o 2._
Assbestos work schedule ❑ Monday ❑ Tuesday 0 Wednesday 0 Thursday 0 Friday ❑ Saturday ❑ Sunday
ift from _❑am❑pm to__❑am❑pm 1Z.
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access to inspect the premises must be provided during the work schedule indicated in this item.
RECENEO
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25.Total amount of asbestos-containing material to be abated during this work - ' :?'BANHN
I5 487 .~Square Feet. and/or 0 Linear Feet FaOGRAM''
TRUG
1' 2
ACP 7
21200+
NYC-WTC 000110681
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